HSA Eligible

Expenses

What Expenses Are Eligible for Reimbursement?

The following table illustrates expenses commonly requested for reimbursement from the Health FSA (Unreimbursed Medical Expense Account) or HSA. This tool is for use by American Fidelity Assurance Company customers and any other use is strictly prohibited. Each item, service, or charge in this table is classified as an eligible expense, potentially eligible expense, or not an eligible expense.

Eligible Expense = eligible for reimbursement under a Health FSA, HRA, or a tax-free distribution from an HSA.Potentially Eligible Expense = sometimes qualifies as eligible depending upon certain facts.Generally Not an Eligible Expense = does not typically qualify as an eligible expense, although a limited exception is available.Not An Eligible Expense = does not qualify as an eligible expense for reimbursement under a Health FSA, HRA, or a tax-free distribution from an HSA.OTC = over-the-counter

American Fidelity does not reimburse capital expenses, even though they may be qualified expenses. Examples of capital expenses include, but are not limited to, exercise equipment, removal of lead-based paint, air conditioner, air purifier, mattresses, pillows or vacuums, water filters, automobile modifications for physically handicapped individuals, home improvements such as exit ramps, widening doorways, etc. to accommodate physically handicapped individuals.

The below information is not all inclusive. Even though you may not see a particular item on one of the below lists, it is not automatically eligible. Please contact us for more information.

Eligible if expense is to assist a physically disabled person; expense of buying, training, and maintaining a guide dog includes the expenses of food and innoculations. Veterinary fees for such animals also qualify as medical care.

Hearing aids (OTC)

Yes

Includes the cost of batteries

Hemorrhoid treatment (OTC)

Yes

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Hospital services

Yes

Immunizations

Yes

Incontinence supplies (OTC)

Yes

Adult diapers used to relieve incontinence generally will qualify. See Diapers.

Insulin

Yes

Includes equipment necessary to inject the insulin, such as syringes or insulin pumps.

For the expense associated with transferring medical records to a new medical practitioner.

Medicines and drugs

Yes

See Drugs and medicines

Norplant insertion or removal

Yes

Obstetrical expenses

Yes

Occlusal guards to prevent teeth grinding

Yes

Optometrist

Yes

Organ donor

Yes

Including surgical, hospital and laboratory services as well as transportation expense for donor.

Orthodontia expenses

Yes

Orthodontia expenses and supplies are eligible. However, when an orthodontic treatment plan is paid up-front at the time of the first visit, the plan may apportion the reimbursements as services are provided during the treatment plan.

Ovulation monitor

Yes

Physical exams

Yes

Physical therapy

Yes

Pregnancy test kit

Yes

Prenatal expenses

Yes

Prosthesis

Yes

Psychiatric care

Yes

Eligible if treating a medical condition. Must submit a medical practitioner's recommendation stating the expense is to treat a specific medical condition, an EOB, or a practitioner's receipt listing the diagnosis code.

Radial keratotomy

Yes

Screening tests

Yes

Must be used for medical diagnosis.

Seeing-eye dog

Yes

See Guide dog.

Sinus medication (OTC)

Yes

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Smoking cessation (stop-smoking) programs

Yes

Sterilization procedures

Yes

Sunscreen with 15 SPF or higher

Yes

Eligible if SPF is 15 or higher. Does not include tanning lotions, make-up or moisturizers, etc., that contain a lower dose of SPF.

Supplies to treat medical condition (OTC)

Yes

Eligible if the medical supply is used to diagnose or treat a specific medical condition and is not a personal comfort item.

Taxes on medical services and products

Yes

Eligible expense to the extent imposed on reimbursable medical care or products.

Telephone equipment for hearing impaired-person

Yes

Expense of buying and repairing special telephone equipment for hearing-impaired person.

Television equipment for hearing-impaired person

Yes

Eligible expense for the equipment that displays the audio part of television programs as subtitles for hearing-impaired individuals. Eligible reimbursement is limited to the cost that exceeds cost of regular item.

Thermometers (OTC)

Yes

Transplants

Yes

Eligible expenses include surgical, hospital and laboratory services and transportation expenses for donors.

Transportation expenses for person to receive medical care

Yes

Eligible expense if travel is primarily for, and essential to, medical care. Includes car and rental car expenses; bus, taxi, train, plan, and ferry fares; parking and tolls; and ambulance services. The standard medical travel mileage rate is 24¢ per mile for 2013, 23.5¢ per mile for 2014, and 23¢ per mile for 2015.

Transportation expenses for someone other than the person receiving medical care

Yes

Transportation costs of an individual (such as a family member) traveling with the individual receiving medical care will qualify as eligible expenses if the presence of the family member on the trip was indispensable to enable the individual to obtain care, such as a parent traveling with a child or a nurse or other person who gives injections, medication, or other treatment required by a patient who is traveling to get medical care and is unable to travel alone. In addition, an individual who travels to visit a mentally ill dependent, if such visits are recommended as part of treatment.

Vasectomy/vasectomy reversal

Yes

Viagra

Yes

Eligible expense if prescribed by a physician to treat a medical condition. See Drugs and medicine.

Walkers

Yes

Wheelchair

Yes

X-ray fee

Yes

Eligible if received for medical reasons.

Potentially Eligible

Expense

Eligible

Special Rules

Acne treatment (OTC)

Potentially eligible

If to treat acne, it is eligible if incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines. However, the cost of regular skin care does not qualify.

Acne treatment - prescription

Potentially eligible

If the expense can be used for both cosmetic and medical (such as Retin-A, which can be used to treat both acne and wrinkles), a physicians recommendation with the medical condition is required.

Allergy medicine (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Alternative healers

Potentially eligible

Nontraditional healing treatments provided by professionals may be eligible if provided to treat a specific medical condition. The treatments must be legal. And the expenses do not qualify if the remedy is a food or substitute for food that the person would normally consume in order to meet nutritional requirements. Drugs and medicines recommended by alternative healers to treat a specific medical condition can qualify as medical care. Drugs and medicines incurred after December 31, 2010 must be prescribed. See Drugs and medicines.

Analgesics (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Antacid (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Antihistamine (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Anti-itch creams (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Antibiotic sprays or ointments (for first aid) (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Aspirin (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Behavioral modification programs

Potentially eligible

See Schools and education

Birth control pills

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Birthing classes/childbirth classes/Lamaze

Potentially eligible

Expenses for a coach, doula or significant other are not eligible. See Lamaze classes.

Calamine lotion (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Childbirth classes

Potentially eligible

Expenses for a coach, doula or significant other are not eligible. See Lamaze classes.

Chondroitin (OTC)

Potentially eligible

Eligible if used primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation is required stating the item is to treat a specific medical condition.

Christian Science practitioners

Potentially eligible

Eligible if expense is for medical care.

Cold medicine (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Contraceptives (OTC)

Potentially eligible

See birth control pills; condoms; Spermicidal foam.

Cough suppressants (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Counseling

Potentially eligible

Eligible if primarily for medical care. Must submit a medical practitioner's recommendation with the medical condition, an EOB, or a practitioner's receipt listing the diagnosis code.

Decongestants (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Diaper rash ointment/cream (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Diarrhea medicine (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Dietary supplements (OTC)

Potentially eligible

Eligible if used primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation is required stating the item is to treat a specific medical condition.

DNA collection and storage

Potentially eligible

Temporary storage may be eligible if collected as part of a diagnosis, treatment or prevention of existing or imminent medical condition. A medical practitioner's recommendation with the medical condition is required.

Drugs and medicines

Potentially eligible

Must be primarily for medical care (and not for personal, general health, or cosmetic purposes), legally procured, and generally accepted as medicines and drugs. In addition, over-the-counter expenses incurred after December 31, 2010, will qualify only if the medicine or drug is prescribed or is insulin. A prescription for this purpose is one written by an individual legally licensed to issue prescriptions, meeting the same legal requirements and including the same information as required for a drug or medicine that is available by prescription only. The prescription must be submitted with the expense reimbursement request but the prescription does not have to be filled by a pharmacist.

Ear plugs (OTC)

Potentially eligible

Eligible if treating a specific medical condition. A medical practitioner's recommendation with the medical condition is required.

Eggs and embryos storage fees

Potentially eligible

Eligible if expense is for temporary storage, but only to the extent necessary for immediate conception.

Eligible to the extent procedure is intended to overcome an inability to have children. Expenses for IVF surrogate not eligible unless the surrogate is a tax dependent.

Fever reducing medications (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Fiber supplements (OTC)

Potentially eligible

Eligible if used primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation is required stating the item is to treat a specific medical condition.

First aid cream and first aid kits (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Fitness programs

Potentially eligible

See health club dues.

Gambling addiction treatment

Potentially eligible

Expense eligible for inpatient treatment at a therapeutic center for gambling addiction.

Genetic testing

Potentially eligible

Eligible if testing is done to diagnose a medical condition or to determine possible defects. However, testing done just to determine the sex of a fetus would not qualify.

Glucosamine (OTC)

Potentially eligible

Eligible if used primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation is required stating the item is to treat a specific medical condition.

Herbal supplements (OTC)

Potentially eligible

See Dietary supplements

Home care

Potentially eligible

See Nursing services

Hormone replacement therapy

Potentially eligible

Eligible if expense is primarily for medical care. Will not qualify if used to maintain general health. Prior to January 1, 2011, a medical practitioner's recommendation is required. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Infertility treatments

Potentially eligible

See Fertility treatments.

Insect bite creams and ointments (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Lamaze class

Potentially eligible

To the extent instruction relates to birth and not childrearing. Expenses for the coach or significant other do not qualify.

Language training for dyslexic/disabled child

Potentially eligible

Eligible if the expense is for a child with dyslexia or an otherwise disabled child. Amounts paid for regular schooling do not qualify. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition.

Laxatives (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Learning disability, instructional fees

Potentially eligible

Eligible if expense is prescribed by a physician. Includes expenses for special school or specially trained teacher for a child who has severe learning disability caused by mental or physical impairment.

Lodging at hospital or similar institution

Potentially eligible

Eligible if principle reason for being there is to receive medical care.

Lodging not at hospital or similar institution

Potentially eligible

Up to $50/night, provided: (1) lodging is primarily for and essential to medical care; (2) medical care is provided in a hospital or medical facility related to or equivalent to licensed hospital; (3) lodging is not lavish; and (4) no element of personal pleasure, recreation or vacation in the travel. If a parent is traveling with a sick child, up to $100 may qualify ($50 for each person).

Lodging of a companion

Potentially eligible

If accompanying a patient for medical reasons and all of the conditions described under Lodging not at a hospital,are also met.

Massage therapy

Potentially eligible

Eligible if expense is to treat a specific injury or trauma. Will not qualify if to improve general health. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition.

Medic-alert bracelet/necklace (OTC)

Potentially eligible

Eligible if expense is recommended by a medical practitioner in connection with treating a medical condition. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition.

Medical conference admission/transportation/meals

Potentially eligible

Eligible if expense relates to a chronic disease suffered by you, your spouse, or your dependent and if the conference is primarily for and essential to the person in need of medical care.

Menstrual pain relievers (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Mentally handicapped, special home for

Potentially eligible

The cost of keeping a mentally handicapped person in a special home (not a relative's home) on a psychiatrist's recommendation to help that person adjust from life in a mental hospital to community living may apply.

Motion sickness pills (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Nasal sprays (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Nasal strips (OTC)

Potentially eligible

Eligible if expense is incurred to treat medical condition. Will not qualify if used for run of the mill snoring. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition.

Naturopathic healers

Potentially eligible

See Alternative healers; Drugs and medicines; Vitamins

Nicotine gum or patches (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Nursing services provided by a nurse or other attendant

Potentially eligible

Expenses incurred, such as wages, employment taxes, and other amounts you pay for nursing services (including extra costs for nurses' room and board) generally will qualify, whether provided in the participant's home or another facility. The attendant doesn't have to be a nurse, as long as the services are those generally performed by a nurse. These include services connected with caring for the patient's condition, such as giving medication or changing dressings, as well as bathing and grooming. But if the person providing nursing services also provides household and personal services only those expenses for nursing services qualify.

Nutritionist's professional expenses

Potentially eligible

Eligible if expense relates to a specifically diagnosed medical condition. Will not qualify if the expense is for general health. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition

Nutritional supplements (OTC)

Potentially eligible

See Dietary supplements.

Over-the-counter medicines (OTC)

Potentially eligible

See Drugs and medicines.

Pain relievers (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Patterning exercises

Potentially eligible

Eligible if expense is for exercises for a mentally handicapped child. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition

Prenatal vitamins

Potentially eligible

If taken during pregnancy (a medical condition). Vitamins taken at other times generally do not qualify.

Propecia

Potentially eligible

Eligible if used to treat a medical condition such as alopecia. When used for cosmetic purposes (i.e., to treat male pattern baldness) it is not an eligible expense. Must be prescribed. See Drugs and medicines.

Psychoanalysis or psychologist

Potentially eligible

Eligible if expense is treating a medical condition. Will not qualify if for the general improvement of mental health, to relieve stress or personal enjoyment. Must submit a medical practitioner's recommendation stating the expense is to treat a specific medical condition, an EOB, or a practitioner's receipt listing the diagnosis code.

Retin-A

Potentially eligible

Eligible if expense is treating a medical condition. Will not qualify if purchased for cosmetic purposes (for example, to reduce wrinkles), even if recommended by a medical practitioner. Prior to January 1, 2011, a medical practitioner's recommendation is required stating the expense is to treat a specific medical condition. Must be prescribed if incurred after December 31, 2010. See Acne treatment; Cosmetic procedures and Drugs and medicines.

Rogaine

Potentially eligible

Eligible if expense is treating a medical condition. Will not qualify if purchased for cosmetic purposes even if recommended by a medical practitioner. Prior to January 1, 2011, a medical practitioner's recommendation is required stating the expense is to treat a specific medical condition. Must be prescribed if incurred after December 31, 2010. See Propecia and Drugs and medicines.

Schools and education, residential

Potentially eligible

Eligible if expense is to treat an individual for behavioral, emotional, or addictive conditions (tuition, meals, and lodging) and the principal reason for attending the program is to receive medical care. If a child is at a school because the courses and disciplinary methods have a beneficial effect on the child's attitude, the expenses won't qualify. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition.

Schools and education, special

Potentially eligible

Eligible if expense is to treat an individual who is mentally impaired or physically disabled to attend a special school (tuition, meals, and lodging) and the principal reason for attending the school is to overcome or alleviate the disability. This includes teaching Braille to a visually impaired person, teaching lip reading to a hearing-impaired person, and remedial language training to correct a condition caused by a birth defect. If a child is at a school because the courses and disciplinary methods have a beneficial effect on the child's attitude, the expenses won't qualify. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition.

Sleep deprivation treatment

Potentially eligible

Eligible expense if the person is under the care of a medical practitioner. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition.

Spermicidal foam (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Sperm, storage fees

Potentially eligible

Eligible if expense is for temporary storage, but only to the extent necessary for immediate conception.

St. John's Wort (OTC)

Potentially eligible

Eligible if used primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation is required stating the item is to treat a specific medical condition.

Stem cell, harvesting and/or storage of

Potentially eligible

Eligible if there is a specific and imminent medical condition that the stem cells are intended to treat. But collection and storage indefinitely, just in case an item might be needed, is not medical care. A medical practitioner's recommendation is required stating the item is to treat a specific medical condition.

Sunglasses

Potentially eligible

Prescription sunglasses would qualify.

Throat lozenges (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Toothache and teething pain relievers (OTC)

Potentially eligible

Eligible if expense incurred prior to January 1, 2011. Must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

Transportation to and from medical conference

Potentially eligible

See Medical conference admission, transportation, meals, etc.

Umbilical cord blood storage

Potentially eligible

Eligible expense if there is an existing or imminently probable disease that the umbilical cord blood is intended to treat, such a newborn who has a birth defect and the cord blood would be needed in the near future. Collection and storage as a precaution to treat a disease or condition that might possibly develop in the future is not medical care.

Vitamins (OTC)

Potentially eligible

Eligible if used primarily for medical care. Will not qualify if used to maintain general health. A medical practitioner's recommendation is required stating the item is to treat a specific medical condition.

Weight-loss programs and/or drugs prescribed to induce weight loss

Potentially eligible

Eligible expense if a physician recommends to treat a specific medical condition (such as obesity, heart disease, or diabetes). Will not qualify if only to improve general health. The costs of food associated with a weight-loss program would not qualify. Prior to January 1, 2011, a medical practitioner's recommendation is required stating the expense is to treat a specific medical condition. Drugs and medicines must be prescribed if incurred after December 31, 2010. See Drugs and medicines.

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Not Eligible

Expense

Eligible

Special Rules

Advanced reimbursements

No

See special requirements under Orthodontia expensesandPrenatal expenses.

Autopsy

No

Babysitting/child care

No

See Dependent daycare expenses.

COBRA premiums

Generally no

Health FSA – Not eligibleHRA – Not eligibleHSA – Eligible expense

Cosmetic procedures or surgery

Generally no

Exception for amounts paid for surgery necessary to improve a deformity arising from a congenital abnormality, personal injury from an accident or trauma, or a disfiguring disease.

Cosmetics

No

Dependent daycare expenses

No

Dependent day care expenses are not eligible medical expenses but may be eligible for reimbursement from a Dependent Day Care FSA

Diapers or diaper service

Generally no

Eligible if expenses incurred to relieve the effects of a diagnosed medical condition, such as urinary incontinence in adults. A medical practitioner's recommendation with the medical condition is required.

Electrolysis or hair removal

No

Face creams, moisturizers (OTC)

No

Face lifts

No

Feminine hygiene products

No

Funeral expenses

No

Hair removal/transplant

No

Health club dues and fees

Generally no

Only in very limited circumstances would fees paid to a health club qualify. Expense is eligible if a physician recommends to treat a specific medical condition (e.g., rehabilitation after back surgery or treatment for obesity). The expense must not have been incurred "but for" the disease (for example, if you belonged to the health club before being diagnosed, then the fees would not qualify). When treatment is no longer needed, the fees would no longer qualify. A medical practitioner's recommendation is required stating the expense is to treat a specific medical condition.

Illegal operations and treatments

No

Insurance premiums

Generally no

FSA – no. For HRA depending on plan design, insurance premiums may be eligible. HSAs can reimburse insurance premiums in limited circumstances. See information at www.irs.gov for more details.

Late fees on medical bills

No

Lodging while attending a medical conference

No

Long term care services

Generally no

FSA – NoHRA – NoHSA - Yes

Marijuana or other controlled substances

No

Missed appointment fee

No

Nursing services for a baby

No

Does not qualify if baby is normal and healthy.

Physician access retainer

No

Prescription drugs and medicines obtained from other countries

No

Prescription drug discount programs

No

A fee paid to get a drug discount card will not qualify; the cost of the prescription may qualify.